Did you know that every year in England there are…

Safer Nursing Care Tool (AUKUH)HURSTPANDABirth Rate+E Rostering

Safer Nursing Care Tool (AUKUH)HURSTPANDABirth Rate+E Rostering

Productive CareSafety Express High Impact ActionsEssence of CareNW Care Indicators

Productive CareSafety Express High Impact ActionsEssence of CareNW Care Indicators

Productive CareSafety ExpressHigh Impact ActionsNurse Sensitive Outcome Measures

Productive CareSafety ExpressHigh Impact ActionsNurse Sensitive Outcome Measures

Real-time MonitoringExperience Based DesignSingle Sex AccommodationPatient Stories

Real-time MonitoringExperience Based DesignSingle Sex AccommodationPatient Stories

High Impact Actions Real-time MonitoringHealth and Well Being

High Impact Actions Real-time MonitoringHealth and Well Being

Get Staffing Right

Get Staffing Right Deliver CareDeliver Care Measure

ImpactMeasure Impact

Patient Experience

Patient Experience

Staff Experience

Staff Experience

People often say the NHS is data rich…….

……..they’re not joking!

– Reduce• Identify what reporting requirements you have to meet

and whether this covers what you want to collect– Reuse

• Think about the overlaps, what can be collected once and reused in another collection mechanism

– Recycle• All data is useful. Use what you have already collected

in retrospective reporting

– Consider triangulating different data sources to give a broader picture

– If you’re going to undertake a new data collection start by carefully considering what you need to answer your question

– Design a collection tool that minimises burden and maximises data quality (i.e. keep it simple!)

Has anyone on the call succeeded in using data to show improvement?

Or have you made some brilliant improvements which you are struggling to

show in your data?

Administrative Point of Care Case Note Review Incident Reporting

Pressure Ulcers

HES at 0.3% (underreported)

No categoryPrevalence

Safety Thermometer 8%Category II – IVPrevalence and

incidenceData over time

each month

Global Trigger Tool ??

Local audit carried out yearly by the TVNs – 3%

incidence

Category III – IV40 on NRLS

(underreported?)

Falls No admin data Safety Cross completed each month – no data

over timeSafety

Thermometer – variation 0 – 2.5%

Global Trigger Tool??

Falls reported through NRLS

35 falls reported last year

Catheters & UTIs

No admin data Safety Thermometer 16%

catheters, 2% catheter and UTI

Yearly audit of catheters

No data

VTE HES at 1% patients with VTE

UNIFY 85% risk assessed

Safety Thermometer

68% risk assessed 66% prophylaxis

2% new VTE

Global Trigger Tool??

Diagnosed with VTE 0.2%

New VTEs after surgery reported

in NRLS3 reported last

year

Administrative Point of Care Case Note Review Incident Reporting

Pressure Ulcers

HES at 0.3% (underreported)

No categoryPrevalence

Safety Thermometer 8%Category II – IVPrevalence and

incidenceData over time

each month

Global Trigger Tool ??

Local audit carried out yearly by the TVNs – 3%

incidence

Category III – IV40 on NRLS

(underreported?)

Falls No admin data Safety Cross completed each month – no data

over timeSafety

Thermometer – variation 0 – 2.5%

Global Trigger Tool ??

Falls reported through NRLS

35 falls reported last year

Catheters & UTIs

No admin data Safety Thermometer 16%

catheters, 2% catheter and UTI

Yearly audit of catheters

No data

VTE HES at 1% patients with VTE

UNIFY 85% risk assessed

Safety Thermometer

68% risk assessed 66% prophylaxis

2% new VTE

Global Trigger Tool -

Diagnosed with VTE 0.2%

New VTEs after surgery reported

in NRLS3 reported last

year

Administrative Point of Care Case Note Review Incident Reporting

Pressure Ulcers

HES at 0.3% (underreported)

No categoryPrevalence

Safety Thermometer 8%Category II – IVPrevalence and

incidenceData over time

each month

Global Trigger Tool ??

Local audit carried out yearly by the TVNs – 3%

incidence

Category III – IV40 on NRLS

(underreported?)

Falls No admin data Safety Cross completed each month – no data

over timeSafety

Thermometer – variation 0 – 2.5%

Global Trigger Tool ??

Falls reported through NRLS

35 falls reported last year

Catheters & UTIs

No admin data Safety Thermometer 16%

catheters, 2% catheter and UTI

Yearly audit of catheters

No data

VTE HES at 1% patients with VTE

UNIFY 85% risk assessed

Safety Thermometer

68% risk assessed 66% prophylaxis

2% new VTE

Global Trigger Tool -

Diagnosed with VTE 0.2%

New VTEs after surgery reported

in NRLS3 reported last

year

Administrative Point of Care Case Note Review Incident Reporting

Pressure Ulcers

HES at 0.3% (underreported)

No categoryPrevalence

Safety Thermometer 8%Category II – IVPrevalence and

incidenceData over time

each month

Global Trigger Tool ??

Local audit carried out yearly by the TVNs – 3%

incidence

Category III – IV40 on NRLS

(underreported?)

Falls No admin data Safety Cross completed each month – no data

over timeSafety

Thermometer – variation 0 – 2.5%

Global Trigger Tool ??

Falls reported through NRLS

35 falls reported last year

Catheters & UTIs

No admin data Safety Thermometer 16%

catheters, 2% catheter and UTI

Yearly audit of catheters

No data

VTE HES at 1% patients with VTE

UNIFY 85% risk assessed

Safety Thermometer

68% risk assessed 66% prophylaxis

2% new VTE

Global Trigger Tool -

Diagnosed with VTE 0.2%

New VTEs after surgery reported

in NRLS3 reported last

year

ResearchJudgementImprovement!!

• View data over time

• View different data sources side by side

• Look for similarities and understand the reasons for differences; don’t be afraid of uncertainty

– Plot as you go; set up a spreadsheet to help you– The more the better; try to measure as often as possible– Print and scribble; annotate your charts to add context

and additional qualitative information– Display your charts for all to see– Assess trends, not absolute numbers– Use run chart or SPC methods to help detect a change– Embrace your analytical resource……

Julie Jones, Patient Safety Lead, Birmingham Community Health Care NHS Trust www.ihi.org for advanced measurement for

improvement

WEST MIDDLESEX UNIVERSITY HOSPITAL NHS TRUSTLONDON SHA

Total falls

Show national benchmark

All

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

Sep-10

Oct-10

Nov-10

Dec-10

Jan-11

Feb-11

Mar-11

Apr-11

May-11

Jun-11

Jul-11

Aug-11

Sep-11

Pressure ulcers

0%

1%

2%

3%

4%

5%

6%

7%

Sep-10

Oct-10

Nov-10

Dec-10

Jan-11

Feb-11

Mar-11

Apr-11

May-11

Jun-11

Jul-11

Aug-11

Sep-11

Falls

0%

5%

10%

15%

20%

25%

30%

Sep-10

Oct-10

Nov-10

Dec-10

Jan-11

Feb-11

Mar-11

Apr-11

May-11

Jun-11

Jul-11

Aug-11

Sep-11

% patients with catheter % patients with catheter AND UTI

Catheters

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Sep-10

Oct-10

Nov-10

Dec-10

Jan-11

Feb-11

Mar-11

Apr-11

May-11

Jun-11

Jul-11

Aug-11

Sep-11

% patients assessed % patients given prophylaxis

VTE

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Sep-10

Oct-10

Nov-10

Dec-10

Jan-11

Feb-11

Mar-11

Apr-11

May-11

Jun-11

Jul-11

Aug-11

Sep-11

No Harms 1 Harm 2 Harms

Harm free care

Total number of patients at selected organisation surveyed to date: 1069Safety Thermometer Results

DashboardStep 1: select SHA Step 2: select organisation

All Total falls

Patients with a new VTE

0%

1%

1%

2%

2%

3%

3%

4%

4%

Sep-10

Oct-10

Nov-10

Dec-10

Jan-11

Feb-11

Mar-11

Apr-11

May-11

Jun-11

Jul-11

Aug-11

Sep-11

Has anyone on the call succeeded in using data to show improvement?

Or have you made some brilliant improvements which you are struggling to

show in your data?

Are there any gaps in the data you collect?